A nationwide prospective study on prescribing pattern of antidepressant drugs in Italian primary care

Eur J Clin Pharmacol. 2013 Feb;69(2):227-36. doi: 10.1007/s00228-012-1319-1. Epub 2012 Jun 17.

Abstract

Purpose: Our purpose was to explore antidepressant drug (AD) prescribing patterns in Italian primary care.

Methods: Overall, 276 Italian general practitioners (GPs) participated in this prospective study, recruiting patients >18 years who started AD therapy during the enrolment period (January 2007 to June 2008). During visits at baseline and 3, 6, and 12 months, data about patients' characteristics and AD treatments were collected by the GPs. Discontinuation rate among new users of AD classes [i.e., selective serotonin reuptake inhibitors (SSRI); tricyclics (TCAs); other ADs) were compared. Logistic regression analyses were performed to identify predictors of AD discontinuation.

Results: SSRIs were the most frequently prescribed ADs (N = 1,037; 75.3 %), especially paroxetine and escitalopram. SSRIs were more likely to be prescribed because of depressive disorders (80 %), and by GPs (51.1 %) rather than psychiatrists (31.8 %). Overall, 27.5 % (N = 378) of AD users discontinued therapy during the first year, mostly in the first 3 months (N = 242; 17.6 %), whereas 185 (13.4 %) were lost to follow-up. SSRI users showed the highest discontinuation rate (29 %). In patients with depressive disorders, younger age, psychiatrist-based diagnosis, and treatment started by GPs were independent predictors of SSRI discontinuation.

Conclusions: In Italy, ADs-especially SSRIs-are widely prescribed by GPs because of depressive/anxiety disorders. Active monitoring of AD users in general practice might reduce the AD discontinuation rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use*
  • Anxiety Disorders / drug therapy*
  • Depressive Disorder / drug therapy*
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / statistics & numerical data
  • Prospective Studies
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Young Adult

Substances

  • Antidepressive Agents
  • Serotonin Uptake Inhibitors